The Correlation Analysis Between Henoch-schonlein Purpura And EB Virus Infection Of Children In Zhangjiakou Area

Objective To explore the correlation between pediatric Henoch-Schonlein purpura(HSP)and EBV infection in Zhangjiakou,discuss the pathogenic role of EBV in HSP,and compare the diagnostic value of five EBV detection methods in children with abdominal HSP.Methods From December 2018 to December 2019,120 children with HSP from the Department of Dermatology and Pediatrics of the First Affiliated Hospital of Hebei North University and 60 children in our hospital physical examination center are collected as the test group and the control group.According to the clinical manifestations,the test group is divided into Group A(simple type),Group B(abdominal type),Group C(kidney type),Group D(joint type)and Group E(mixed type).Then statistical analysis is performed on the difference of general conditions and the rate of EBV infection between the test group and control group,and on the age distribution,incidence season,the difference of EBV infection rate among different types of HSP in the test group;Finally,five EBV detection methods are used to compare and analyze the diagnostic value of abdominal HSP.All Data is analyzed by SPSS25.0 statistical software.Results In the 120 cases of test group,there are 66 males and 54 females,aged 4-14 years,with an average age of 7.55±2.57 years;Among the 60 cases in the control group,there are 35 males and 25 females,aged 4-14 years,with an average age of(7.58±2.61)years.There is no statistical difference in age and sex composition between the test group and the control group.In the test group,the number of positive cases of EB V-DNA load of throat swabs is 44 cases,the positive rate is 36.7%,and the number in the control group is 8 cases,the positive rate is 13.3%.The chi-square test of the data obtained is χ2=10.601,P<0.05,which are statistically different;The infection rate of EBV in the test group is significantly higher than that in the control group.Among the test group analyzed by the age of onset,the positive rates of EBV-DNA load in throat swabs of preschool(4-6 years)、school age(7-11 years)and adolescent(12-14 years)are respectively 49.2%,25.0%,23.%,by the Fisher exact test(P=0.021<0.05),which are statistically different.The positive rate of preschool age is significantly higher than that in school age(P<0.025).In the test group analyzed by the weather of onset,the positive rates of EBV-DNA load of throat swabs are 33.3%in spring(March to May),6.3%in summer(June to August),45.9%in autumn(September to November),and 43.2%in winter(December to February)by the Chi-square test(χ2=8.579,P<0.05),which is statistically significant.The main clinical manifestations of HSP of children are skin ecchymosis(100.0%),abdominal discomfort(35.0%),kidney damage(26.7%)and joint swelling and pain(37.5%),which are divided into Group A、Group B、Group C、Group D and Group E separately.Among the five groups,the positive rates of EBV-DNA load of throat swabs are 25.0%,64.5%,30.4%,25.0%and 27.3%respectively,by the Fisher exact test(P=0.009<0.05)showing statistical differences.Furthermore,comparing Group A、Group B、Group C、Group D with Group B separately,the Group B,abdominal type,is significantly higher than group D and group E,which is statistically different(P<0.0125).The children in group B,abdominal type,are given detection methods of EBV-DNA load of throat swabs,EBV-DNA load of peripheral blood,anti-EB virus capsid antigen IgM antibody(anti-VCA-IgM),anti-EB virus early antigen IgG antibody(anti-EA-IgG)and anti-EBV capsid antigen IgG affinity(anti-VCA-IgG affinity).The sensitivity of the five detection methods are 64.5%,61.3%,32.3%,38.7%and 29.0%respectively;The specificity are 73.0%,78.7%,85.4%,84.3%and 93.3%respectively;The total consistent rate are 70.8%,74.2%,71.7%,72.5%and 76.7%respectively;The odds product are 4.92,5.83,2.78,3.38 and 5.65 respectively;The positive predictive value are 45.5%,50.0%,43.5%、46.2%and 60.0%respectively;The negative predictive value are 85.5%,85.4%,78.4%,79.8%and 79.0%respectively;The area under the ROC curve are 0.688,0.700,0.588,0.615,0.611 respectively.Conclusion 1.The infection rate of acute EBV in children with HSP is significantly higher than that in healthy children.2.Among all types of children with HSP,the rate of EBV infection in children with abdominal HSP is significantly higher than that of kidney type and mixed type.3.The sensitivity of EBV-DNA detection of throat swabs and peripheral blood in children with abdominal HSP is higher than that of EBV-related antibody detection.